Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 099.0134129 | VT |
NPI | 1104423813 |
---|---|
Provider Name | Lauren Elizabeth Mandych |
First Address | Montpelier, VT 05602-4257 |
Second Address | Montpelier, VT 05602-4257 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2020 |
Last Update Date | 06/10/2020 |